Introduction: The increasing use of minimally invasive orthopedic procedures has led to a greater reliance on fluoroscopy, resulting in elevated radiation exposure for surgeons. This study aimed to evaluate the knowledge, awareness, and daily practices of orthopedic surgeons regarding radiation safety in an academic hospital. Understanding radiation safety is crucial to minimize patient exposure and prevent adverse effects on surgeons. Methods: This cross-sectional study was conducted at the Department of Orthopedics of different tertiary care hospitals in Rawalpindi, Pakistan. Data were collected prospectively for two years, and a total of 505 participants, including residents, consultants, and operation theatre assistants, completed a questionnaire. The questionnaire was validated by experts and covered information on fluoroscopy usage, frequency of surgeries, awareness of radiation safety, and protective measures. Ethical approval was obtained, and data were analyzed using SPSS version 26.0. Results: The majority of participants were male (74.1%), and the sample included various ranks of orthopedic surgeons. Only 56.2% of participants were aware of the usage of fluoroscopy, and 40.2% had read some research on the topic. While 44.6% used lead aprons for radiation protection, the usage of other protective measures and dosimeters was limited. The mediation analysis showed an insignificant indirect association between the rank of orthopedic surgeons, number of surgeries performed, and fluoroscopy usage as a mediator. Awareness and reading research on fluoroscopy were significantly associated with radiation protection. Conclusion: The knowledge, awareness, and daily practices of orthopedic surgeons regarding radiation safety in fluoroscopy use need improvement. The findings emphasize the importance of implementing training programs, providing radiation protection devices, and ensuring compliance with safety guidelines.

Objective: Assessment of the functionality in patients with supracondylar fracture of femur managed with intermedullary tibial nails. Study Design: Case Series Study. Place and Duration of Study: We conducted a prospective cohort study for 6 months, from September 2021 to February 2022. Materials and Methods: 25 adult patients presented in the accidents and emergency department of Railway General Hospital, Rawalpindi. They were managed using tibial nail and their functionalities after the operations were managed using the Tegner-Lysholm Criteria measured at 2 weeks, 6 weeks, and 12 weeks till union achieved. Results: Five of our patients were females and twenty males. Average healing time was calculated at 15 weeks and 6 days approximately (2.646 SD) 24% (n=6) showed excellent healing, 48% (n=12) had good results and 28% (n=7) had fair results. We did not observe any complications. Conclusion: Tibial nails are convenient and effective to manage the patients with supracondylar fracture of ffemur and show good functional outcomes.

The objective of this study was to evaluate the effectiveness of dexamethasone in treating postoperative pain in patients undergoing total knee arthroplasty (TKA). MethodologyThis randomized controlled trial (RCT) was completed over the course of two years (September 7, 2015, to September 6, 2017. In the course of their treatment for osteoarthritis of the knee, all of the patients who had primary unilateral total knee replacement (TKR) participated in the research. Under spinal anesthesia, each patient had medial para-patellar approach medial orthopedic surgery. Patients were assigned to group A or group B based on a random selection. Each of the groups consisted of 79 individuals. Group A was given dexamethasone through intravenous administration at a dose of 0.1 mg/kg before the operation. During the subsequent period of 24 hours, no more treatment was administered (control group). On a predesigned questionnaire, postoperative pain was measured using the visual analog scale (VAS) for pain. Functional results, duration of hospital stay, and complications were all recorded on the questionnaire (VAS). Analysis of data was carried out using the Statistical Package for the Social Sciences (SPSS) version 23 (IBM SPSS Statistics, Armonk, NY, USA). ResultsThere were 158 patients in total in the study, out of which 98 were females and 60 were males in the group.The patients' average body mass index (BMI) was 26.94 ± 3.14 kg/m 2 . Patients in group A had lower postoperative analgesic and antiemetic needs and higher VAS scores and spent less time in the hospital than patients in group B. There were no postoperative problems in either group. ConclusionIn patients undergoing TKA, the use of dexamethasone during and after surgery decreases pain, the need for analgesics, and the duration of hospital stay.

Introduction Supracondylar humerus is one of the most common elbow fractures in children. It accounts for about 60% of all the elbow fracture. It is a challenging orthopedic presentation. It is more common in the children younger than 15. The bending structure and weak metamorphic sclerotin of distal humerus are the underlying cause behind these fractures. Fractures are classified according to the Gartland’s criteria. Study design: It is a retrospective study conducted at Sahara Medical College, Narowal and Pakistan Railway General Hospital, Rawalpindi for duration of six months from August 2022 to January 2023. Material and Methods: The patients were aware of the study objective. The demographic features of each selected patient were recorded. There were total 150 patients included in this study. Patients were divided into three groups on the basis of type of approach used for the treatment of supracondylar humerus fracture; lateral approach, medial approach and posterior approach as group A, B and C respectively. Results: The average age of patients was 7.61±4.5, 7.2±3.6 and 6.5±4.5 years for group A, B and C respectively. The reason of fracture was determined and the data revealed that most of the injuries were related to sports. P value was calculated and the data was statistically significant. Conclusion: Our results suggest that as compared to posterior and medial, lateral approach is better as it showed significant radiological and functional outcomes. It can be used by surgeons as it takes less time and the complications rate is lower. Keywords: lateral approach, supracondylar humerus and posterior approach.

Background: A displaced mid-shaft clavicle fracture in an adult is a break in the collarbone, which is the long bone that runs from the shoulder to the chest. Mid-shaft fractures occur in the middle portion of the collarbone and the displaced fracture means that the broken pieces have moved out of their normal alignment. Study design: It is a comparative study conducted at Orthopedics Department of Pakistan Railway General Hospital, Rawalpindi for the duration of six months from Jan 2022 to June 2022. Material and Methods: The patients who were treated without operation were compared with operative patients for better results. Both groups contained 60 patients. The average age of the patients was 29.9±7.8 in the control group and 32.1±8.1 in the non-operative group. There were 32 and 28 patients in control group that had right and left side of injury respectively. This study was approved by the ethical and the review board committee of the hospital. The data was collected and statistical analysis was performed. Results: The functional outcome of the patients is constant score fracture was calculated and clavicle shortening was carefully observed. The average shortening of clavicle was 0.71±8.1 cm. After a follow-up of 3 months’ clavicle shortening was calculated. The outcome was linked to amount of clavicle shortening among patients Conclusion: The study was done to find the functional outcome of non-operatively treated displaced mid-shaft clavicle fractures in the adult as compared with the operatively treated patients. The results showed that non-operative management of minimally displaced mid shaft clavicle fracture also had good functional outcome. Keywords: Clavicle fracture and the non-operative treatment.